Ronald Wade Cottle, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30015 Issued in NC

Practice address

103 S Owen St
Elizabethtown, NC 28337-8878

Phone

(910) 862-2900

Fax

(910) 862-2900

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Obstetrics/Gynecology

Education

University of North Carolina at Chapel Hill School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Regional Physician ServicesGroup PAC ID 7012058548, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1427282045
  Medicare reassignment Care Compare group NPD
• Bladen Healthcare LLC

  • Critical Access Hospital
  • Elizabethtown, NC
  • NPI 1558537282
  Medicare reassignment NPD
• Bladen Healthcare LLC

  • Rural Health Clinic/Center
  • Whiteville, NC
  • NPI 1821764390
  NPD
• Bladen Healthcare, LLC

  • Rural Health Clinic/Center
  • Bladenboro, NC
  • NPI 1417123993
  NPD
• Southeastern Regional Physician Services

  • Multi-Specialty Clinic/Center
  • Lumberton, NC
  • NPI 1265165518
  NPD
• Columbus Regional Health Network

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1518263268
  NPD (past)
• Inland Cardiology Associates, P.S.

  • Cardiovascular Disease Physician
  • Spokane, WA
  • NPI 1679522106
  NPD (past)
• KB Management Services LLC

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1053459818
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeastern Regional Medical Center

  • General Acute Care Hospital
  • Lumberton, NC
  • NPI 1427030774
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558334201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284720790",
            "telephone_number": "910-641-0400",
            "fax_number": "910-642-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S OWEN ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283378878",
            "telephone_number": "910-862-2900",
            "fax_number": "910-862-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTLE",
        "first_name": "RONALD",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "30015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7924670",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "24670",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Innovations, Inc.
• Community Innovations, Inc.
• Debra Conner, R.N.
• Coordinated Health Services, Inc.
• Cottle Medical Group PA
• County of Bladen
• County of Bladen
• County of Bladen Office of Auditor
• County of Bladen Office of Auditor
• County of Bladen Office of Auditor

• Family Medicine Physician in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.